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European Respiratory Journal ; 58:3, 2021.
Article in English | Web of Science | ID: covidwho-1700040
Italian Journal of Medicine ; 15(3):71, 2021.
Article in English | EMBASE | ID: covidwho-1567763


Background and Aim: Pulmonary involvement from CoViD-19 is frequent, after acute phase dyspnoea, cough, desaturation, respiratory insufficiency, can persist, pneumonia leads to interstitial disease (ground- glass) and to pulmonary fibrosis (honeycomb lung). A diagnostic algorithm can be a simple way for differential diagnoses (pulmonary embolism, PE) and to set up therapies in a systematic way. Our objective was to propose a simple and easy diagnostic algorithm, to identify with chest CT scan, excluding PE in high dimer- D patients, suggestive gait test and compatible objectivity. Methods: Prescription of: blood tests, radiological (CT chest CMC or High Resolution), respiratory physiopathology (Walking test, Global spirometry, Plethysmography, DLCO). Set drug therapies in case of PE, oral steroid (OCS) in case of extensive interstitial disease, long-acting beta 2 agonist bronchodilators (LABA), antimuscarinics (LAMA), inhaled steroids (ICS). For fibrosis and a honeycomb pattern, treatment with dipalmitoylethanolamide (PEA). Results: 258 outpatients, average 60.68 years, 115 women, 143 men, with an urgent request for pneumological visit and treated on an outpatient basis. 1 pt died during treatment, 4 pts were diagnosed with pulmonary embolism. 4 pts required a prescription for oxygen therapy. 228 pts presented ground-glass, 30 pts showed normal chest CT. Conclusions: DLCO shows progressive improvement in values after ICS treatment. Small pathway deficiency evidenced by spirometry can be treated with LABA-LAMA especially in patients with a previous history of cigarette smoking or COPD.

Italian Journal of Medicine ; 15(3):9, 2021.
Article in English | EMBASE | ID: covidwho-1567708


Aim of the study: The aim of the study was to determine the influence of fascial and soft tissue treatment on respiratory efficiency and chest mobility of men and women between 22 and 54 years old. Materials and Methods: Subjects between 22 and 54 y.o., vaccinated or healed from CoViD-19 and without any other pathologies were recruited. Fascial and soft tissues manual treatment was made on mesentery's roots, right pillar of diaphragm and ileocecal valve. Spirometry was executed before and after the treatment. Patients had been adequately instructed on how to make a spirometry. Results: FEV1 showed an average increase of 2% meanwhile FEF2575 showed an average increase of 14.38% [from 0.26% to 31.76%]. Conclusions: Although FEV1's improvement is not indicative, there is an improvement in FEF2575 indicating better spontaneous return of the diaphragm to its resting state after the treatment. The treatment doesn't act on filling because we have seen that the increase in FEV1 is not significant but it affects emptying so it could be interesting to evaluate how patients are able, after the treatment, to better empty themselves and, since better emptying is a prerequisite for better filling, whether and how the residual functional capacity improves. It is as if with the treatment we had made patients learn to better empty themselves, getting therefore a more elastic return of the diaphragm in its relaxed position. There is a gain except for smokers who always remain hyperinflated emphasizing then how the share of emphysema is already measurable for the smoker.